Risk of Arrhythmia and Mortality from Macrolide Antibiotic Prescription: A Population-Based Cohort Study
Master of Science
Epidemiology and Biostatistics
Dr. Amit Garg
Many respiratory tract infections are treated with macrolide antibiotics. Regulatory agencies warn that these antibiotics increase the risk of ventricular arrhythmia. This population-based retrospective cohort study examined the 30-day risk of a hospital encounter with ventricular arrhythmia and all-cause mortality in 503,612 matched pairs of older adults who received a new outpatient prescription for an oral macrolide antibiotic and those prescribed referent antibiotics from 2002 to 2013 in Ontario. Conditional logistic regression was used to measure the association between macrolide exposure and outcomes. Macrolide antibiotics compared with referent antibiotics were not associated with a higher 30-day risk of ventricular arrhythmia (0.03% vs. 0.03%, relative risk [RR] 1.06, 95% confidence interval [CI] 0.83- 1.36), and were associated with a lower risk of 30-day all-cause mortality (0.62% vs. 0.76%, RR 0.82, 95% CI 0.78-0.86). These findings suggest that current warnings from Health Canada and the U.S. Food and Drug Administration may be overstated.
Trac, Mai H., "Risk of Arrhythmia and Mortality from Macrolide Antibiotic Prescription: A Population-Based Cohort Study" (2015). Electronic Thesis and Dissertation Repository. 3251.